Sealing lip device for a respiratory mask, respiratory mask and a method and mould for producing the same

ABSTRACT

A sealing lip device for a breathing mask includes a receiving opening for receiving at least the nose tip region of a mask wearer, a sealing lip which is formed from an elastomeric material and which surrounds the receiving opening and which is configured to cross the bridge of the nose and which has a contact zone provided for bearing against the face of a mask wearer in use. The sealing lip is elastically and yieldingly arranged in such a way that a first sealing lip zone which in use seals the region of the bridge of the nose has a higher degree of flexibility than a second sealing lip zone which in use is adjacent to at least one of the nostrils and the upper lip of the mask wearer in the application position of the breathing mask. The sealing lip includes a folding bellows structure that suspends the sealing lip in the region of the first zone provided for sealing of the region of the bridge of the nose. The folding bellows structure includes a fold indentation having zones of differing wall thickness.

This application is a continuation of application Ser. No. 10/220,018, filed Aug. 26, 2002, now U.S. Pat. No. 7,827,990, which is the U.S. National Phase of International Application PCT/EP00/01586, filed Feb. 25, 2000, which designated the U.S. and the International Application was not published under PCT Article 21(2) in English, each of which is incorporated herein by reference in its entirety.

The invention concerns a sealing lip device for a breathing mask, a breathing mask per se and a method and a mold for producing same.

In particular the invention concerns breathing masks which can be fitted to the nose region in sealing relationship and which have a sealing device extending in the region of the upper lip of the mask wearer between the mouth and the nose. Breathing masks are used in particular in the medical and technical areas for the feed of a respiratory gas, in particular under an increased pressure.

In those breathing masks, a seal in relation to the surface of the face of a wearer is usually achieved by a peripherally extending sealing lip made from an elastomeric material.

The sealing action achieved with a sealing lip of that kind generally increases with the pressure with which the sealing lip is pressed against the surface of the face. However the level of wearing comfort is adversely affected by comparatively high contact pressures. Depending on the respective sensitivity of the mask wearer long-term use of the known breathing masks gives rise to troubles.

The object of the present invention is to provide a breathing mask in which a high level of sealing action can be reliably achieved, with a high degree of wearing comfort.

In accordance with the invention that object is attained by a sealing lip device for a breathing mask having a receiving opening for receiving at least the nose tip region of a mask wearer, a sealing lip which is formed from an elastomeric material and which surrounds the receiving opening and which crosses the bridge of the nose in the application position and which has a contact zone provided for bearing against the face of a mask wearer, wherein the sealing lip is elastically yieldingly arranged in such a way that in the region of the bridge of the nose there is a higher degree of flexibility than in the region of the nostrils and/or the upper lip.

That advantageously affords a high degree of compatibility with the most widely varying facial architectures, with a high level of wearing comfort. The breathing mask according to the invention is distinguished in particular in the region of the bridge of the nose by a high degree of sealing integrity, without considerable pressures in relation to surface area occurring in that respect. The high level of sealing effect achieved in the region of the bridge of the nose effectively obviates in particular eye irritation effects and feeling the effects of drafts.

In accordance with a particularly preferred embodiment of the invention the defined flexibility of the sealing lip zone which fits on the region of the bridge of the nose is achieved by the sealing lip device being suspended in the region of that zone on a bellow structure. That bellows structure is preferably dimensioned in such a way that it forms an abutment device, upon suitably deep penetration of the bridge of the nose. The abutment surfaces which come into effect there are preferably such that they form a comparatively large contact area, at the latest in the inwardly resiliently deflected condition, so that even when the bellows structure becomes operative in the resiliently inwardly deflected condition, the arrangement does not involve any unacceptably high pressures in relation to surface area.

In a particularly advantage fashion, a hinge characteristic which is defined by different wall thicknesses is imparted to the bellows structure. Preferably the bend or hinge location is of a comparatively thin-gauge nature, whereas the zones which are disposed therebetween are slightly thicker. As an alternative thereto or also in combination with that measure, it is also possible to provide rolling bellows structures, by virtue of suitable wall thicknesses.

In a particularly advantageous manner the bellows structure has a plurality of fold indentations. Preferably at least one fold indentation extends from the region of the bridge of the nose into a region adjacent to the nostrils in the position of use of the mask.

Particularly when the structure has a plurality of fold indentations preferably at least one thereof extends around the entire periphery of the sealing lip device. The spring characteristic of the respective fold indentation can be definedly established for given peripheral zones in such a way that there is a higher level of flexibility in the region of the bridge of the nose and there is a lower level of flexibility in the region of the upper lip or in particular in the region of the nostrils. (Those orientations are with reference to the application position of the mask).

Particularly when using the bellows structure in the sealing zone region of the bridge of the nose, the sealing device is preferably designed in such a way that the flexibility of the sealing lip, which is in opposite relationship to the application direction, is so matched that there is an adaptation or articulation axis in the nostril or upper lip region. That makes it possible for the corresponding breathing mask to be fitted to the face of the mask wearer predominantly in the region of the zones of the face which are adjacent to the nostrils and on the upper lip, in which respect the preferably extremely thin-wall sealing lip zone which is provided for sealing at the bridge of the nose can be pivoted with respect to the mask frame, in accordance with the facial architecture. By virtue of the internal pressure obtaining in the mask, that pivotably supported sealing lip zone can then be uniformly pressed against the bridge of the nose of the wearer of the mask, without in that situation the occurrence of surface pressures which considerably exceed the internal pressure of the mask.

The particularly advantageous kinematics and hinge characteristic of the mask cushion or pad formed by the sealing lip device can in particular be achieved by local zones with a higher load-bearing capability being provided in the region of the sealing lip, which is adjacent to the nostrils or the upper lip.

In accordance with a particularly preferred embodiment of the invention the zones of higher load-bearing capability are formed by locally thickened zones of the sealing lip. The transition of the locally thickened zones is preferably effected along regions in the manner of the edge of a lens, or also in a shallowly terminating configuration, possibly without the transition between the zones being clearly perceptible.

In accordance with a particularly preferred embodiment of the invention the locally thickened zones are supported on a mask frame zone by way of a support structure which is formed in the sealing lip. That mask frame zone is preferably of a thick-wall nature and in that respect involves a wall thickness in the range of between 3 and 6 mm.

The zones of higher load-bearing capability are preferably of a pad-like nature, as is shown by way of example in FIG. 1 to which reference will be subsequently made in greater detail.

A form of support for the mask pad, which is particularly advantageous from ergonomic points of view is achieved if the zones of higher load-bearing capability, in the region of the face-contact zone, are each of a substantially crescent moon-shaped configuration. The limbs of those zones of higher load-bearing capability, which are provided in the region for bearing against the upper lip, are preferably of a shortened configuration in such a way that a zone of high elasticity and flexibility in opposite relationship to the application direction is provided in the region of the upper lip between the zones of higher load-bearing capability. That higher degree of flexibility can advantageously be achieved by also providing here a local fold structure or a correspondingly thin-walled zone.

In accordance with a particularly preferred embodiment of the invention the sealing lip device is mounted to a mask base body. The mask base body can also be formed from an elastomeric material, for example silicone rubber. In accordance with a particularly preferred embodiment of the invention however the mask base body is formed by a hard shell, for example comprising a fully transparent material. The hard shell preferably has a conduit connection facing in the application position towards the forehead region of the mask wearer. As an alternative thereto it is also possible for the hard shell to be provided with a central or lateral connecting structure for coupling a respiratory gas conduit.

Mounting the sealing lip device or the sealing pad to the hard shell or a mask base body is preferably effected by using a coupling structure. In accordance with a particularly preferred embodiment of the invention that coupling structure comprises, on the part of the hard shell, a peripheral bead portion and, on the part of the sealing lip device, a frame portion with a complementary receiving groove. The groove and the bead are preferably such that in the case of an expansion of the mask pad, caused by mask internal pressure, in the region of the coupling structure, there are surface pressures which are always higher than the internal pressure in the mask. That provides for a particularly reliable sealing action, without the addition of adhesives.

In a particularly advantageous fashion, there are provided means for fixing the position of the sealing lip device with respect to the hard shell in the peripheral direction. Those means can be formed for example by positioning projections or in particular by apertures in the peripheral bead.

A prestressing is preferably imparted to the sealing lip device, which prestressing is advantageously achieved by elastic deformation upon coupling to the hard shell. That makes it possible to definedly influence the deformation characteristics of the sealing lip device. In particular it is possible to prestress given zones of the sealing lip device in such a way that the formation of wrinkle folds in the region of the face-sealing zone is advantageously precluded.

In accordance with an advantageous embodiment of the invention the frame portion is such that it extends substantially in one plane. That permits the hard shell to be of a comparatively flat structure and allows the mask pad to be prestressed in a simple fashion.

As an alternative thereto however it is also possible for the mask arrangement to be designed in such a way that the frame portion is of a configuration which advances in the region of the articulation axis relative to the zone of high load-bearing capability. That makes it possible to already impart to the hard shell itself a configuration which substantially corresponds to the statistically most probable facial architecture.

Advantageously the wall thickness of the thin zone is in the range of between 0.65 and 1.85 mm. That wall thickness imparts to the mask a resistance to pressure which is sufficient even in the case of mask pressures in the region of 15 mbars.

The wall thickness of the zone of high load-bearing capability is preferably in the range of between 0.80 and 4 mm.

In accordance with a particularly preferred embodiment of the invention the mask pad is produced by a multi-stage mold cavity filling method. That makes it possible to impart to the zone of high load-bearing capability, a coloring which differs from the zone of low load-bearing capability. It is also possible to definedly match the mechanical properties of the materials respectively used for the respective zone.

The zone of high load-bearing capability is preferably formed by two elastomeric portions which project up from the lower corner region of the frame portion and which pass out into the sealing lip in the form of flat limbs. The sealing lip itself is preferably formed from an elastomeric material, in particular fully transparent silicone rubber. The outside surface of the mask pad, which comes directly into contact with the face of the mask wearer, is preferably of a velvety matte finish. That affords an improved feel when wearing the mask.

An embodiment of the invention which is particularly advantageous from manufacturing procedure points of view is afforded if the hard shell is injection molded to the sealing lip device. Besides particularly reliable coupling of the hard shell or the mask base body and the mask pad, that also precludes the formation of a gap, which is disadvantageous from bacteriological points of view.

In regard to a method of producing a sealing lip device for a breathing mask, the above-specified object is attained by an elastomeric material being introduced into a mold cavity formed by a mold, at least partially setting in the mold cavity, and being removed from the mold after opening thereof, wherein the elastomeric material is introduced into the corresponding mold cavity in two steps which occur in succession in time.

In that way it is possible to provide a mask pad which has a single sealing lip which in the application direction affords flexibility which is defined in accordance with the load-bearing capability and the statistically expected architectural variance of the corresponding zone of the face.

Advantageously, a carrier structure of the sealing lip device and a thin-wall zone of the sealing lip are formed in steps which are separate in terms of time, and possibly using materials involving different mechanical properties and possibly color.

Preferably the carrier structure is formed in a first injection step and the thin-wall zone is formed in a subsequent second injection step. The operation of introducing the respective material is preferably effected by injection or beforehand by suitably introducing same into the mold cavity to fill it.

The mold cavity which is provided for filling with the material forming the thin-wall zone is preferably defined by a mold which delimits the outside of a sealing lip being lifted off a core which delimits the inside of the sealing lip.

As an alternative thereto it is also possible for the carrier structure to be formed by a mold cavity which is defined by a core delimiting the inside of a sealing lip and an outer mold, wherein to form the thin-wall zone of the sealing lip the outer mold is changed and then the material for forming the thin zone is introduced into the mold cavity which is now present and which is intended for the thin-wall zone, and sets therein.

In the mold aspect of the invention, the above-specified object is attained by a mold for producing a sealing lip device for a breathing mask, comprising a mold core device which in conjunction with an outer mold defines a mold cavity having a fold portion.

It is advantageously possible in that way to produce the sealing lip device for example in the context of a fully automated silicone injection molding method.

In accordance with a particularly preferred embodiment of the invention the outer mold is of a multi-part nature. Preferably the outer mold comprises a mold half which delimits the outside surface of the sealing lip and a mold half which co-operates with said mold half and which delimits the rest of the region of the outside surface of the sealing pad. The inner region of the sealing pad is delimited by a preferably integral core device. With the described two-part embodiment of the outer mold, it is possible for an outer mold half to be withdrawn along a mold-opening axis which extends in a direction in opposite relationship to the side at the bridge of the nose or a direction remote from the upper lip sealing zone. The bellows zone which is locally provided in the region of the bridge of the nose and the mold-opening axis as well as the configuration of the coupling frame of the mask pad are preferably matched in such a way as to afford mold-opening angles at least in the region of 2°.

In particular in this case the outside of the sealing lip, which is towards the mask wearer, is preferably formed by an outer mold portion in conjunction with the mold core device, wherein the outer mold portion has a peripherally extending mold cavity channel which defines the outside of the sealing lip.

The outer separation edge of the mold cavity channel preferably extends in the region of the outer peripheral edge of the sealing lip. That advantageously avoids any burrs in the region of the face-contact surfaces.

In accordance with a particular aspect of the invention, an embodiment, which can be particularly advantageously implemented from production procedure points of view, of a leakage device for the discharge of at least partially consumed respiratory air into the ambient atmosphere is afforded by a breathing mask having a mask body and sealing pad device which is formed from an elastomeric material and which in conjunction with the mask body delimits a mask internal space and an outlet device for the discharge of at least partially consumed respiratory gas out of the mask internal space, wherein the outlet device has a flow path portion which is at least partially defined by the sealing pad device.

This measure can also be used independently of the above-described design configurations. Advantageous developments of this combination of the invention, which is independent per se, are set forth in the appendant claims.

Further advantageous configurations of the invention are recited in the appendant claims.

Further details of the invention will be apparent from the description hereinafter with reference to the drawing in which:

FIG. 1 a shows a perspective view of a mask pad in accordance with a first embodiment of the invention with a local bellows structure and pad-like zones of increased load-bearing capability in the region of the sealing lips adjacent to the nostrils in the application position, together with associated FIGS. 1 b, 1 c, and 1 d for illustration and accompanying explanation,

FIG. 2 shows a simplified side view of a further breathing mask with a fold indentation and a frame portion extending substantially in one plane,

FIG. 3 a shows a simplified side view of a further embodiment of a mask pad, also with a bellows-like fold indentation and an indicated adaptation or articulation axis,

FIG. 3 b shows a simplified side view of a further embodiment of a breathing mask with a fold provided only in the rear third of the mask pad,

FIG. 4 shows a simplified plan view of a sealing lip and diagrams for qualitative illustration of preferred matching of the load-bearing capability of the sealing lip,

FIG. 5 a shows a view in section to describe a preferred embodiment of a fold region with a hinge characteristic established by zones of differing wall thicknesses,

FIG. 5 bshows an enlarged view of a portion of the sectional view illustrated in FIG. 5 a,

FIG. 5 c is diagrammatic sketch showing the mechanics of the microsealing lip structure of FIG 5 a,

FIGS. 6, 6 a, 6 b, 6 c, 6 d, 6 e, 6 f and 6 g show diagrammatic views to describe preferred cross-sectional configurations in the case of a sealing lip according to the invention,

FIG. 7 shows a diagrammatic view to describe the flexibility of the hinge-like suspension for a sealing lip,

FIG. 8 shows a diagrammatic view to describe a preferred measure for fixing the mask pad in the peripheral direction,

FIG. 9 shows a further diagrammatic view to describe a preferred structure of a mold in conjunction with advantageous configurations of a mask base body (hard shell),

FIG. 10 shows a simplified view in section to describe a fold portion with a plurality of fold indentations and a defined hinge characteristic,

FIG. 11 shows a perspective view of a further preferred embodiment of a breathing mask with a mask sealing pad provided with a local bellows structure,

FIG. 12 shows a perspective view of the breathing mask of FIG. 11 from below,

FIG. 13 shows a simplified view in section through the sealing device which is disposed on the upper lip, to describe the substantially smooth-wall transition of the sealing lip into the hard shell mask body,

FIG. 14 a shows a simplified view in section through a sealing lip with integrated leakage opening,

FIG. 14 b shows a simplified view in section through a sealing lip with integrated leakage opening, but with a flow path partially delimited by the mask frame,

FIG. 14 c shows a simplified view in section through a sealing lip with integrated leakage opening, with a flow path which is formed in the mask frame and which passes into the sealing lip frame portion,

FIG. 14 d shows a simplified view in section through a sealing lip with integrated leakage opening, but with mutually aligned passages in the hard shell and the sealing lip device,

FIG. 14 e shows a simplified view in section through a sealing lip with integrated leakage opening, but with a portion which is extended upwardly in a bib-like configuration from the interior to a through opening, and with a through opening formed therein,

FIG. 14 f shows a side perspective view of the sealing pad device of FIG. 14 b,

FIGS. 15 a, 15 b, 15 c and 15 d show simplified diagrammatic views of preferred cross-sections of the flow paths, and

FIG. 16 shows a simplified diagrammatic view in principle to describe preferred leakage zones.

The sealing lip device which is shown in FIG. 1 a and which is in the form of a mask cushion or pad 1 is made from an elastomeric material, here transparent silicone rubber.

The mask pad 1 includes a sealing lip 3 which extends around the nose receiving opening 2. The sealing lip 3 has an outer surface which is curved convexly in the embodiment illustrated here.

The sealing lip 3 is of such an arrangement and configuration that it has, of itself, zones of differing load-bearing capability. In the embodiment illustrated here that is achieved by suspension, which is flexible in opposite relationship to the application direction Z, of the sealing lip zone a provided for bearing against the bridge of the nose (see FIG. 1 b).

In addition thereto, in the region of the zone b1, b2 (FIG. 1 b) adjacent to the nostrils, the sealing lip 3 is of such a configuration that here it is of a higher load-bearing capability. That provides for pivotability of the mask pad about an adaptation axis X, which extends transversely through the mask pad in the region identified in FIG. 1 bby the letter e.

The higher load-bearing capability is achieved here by zones 4 which are thickened in a pad-like manner and which here advantageously run into the sealing lip 3 in a crescent moon-like configuration. The zones 4 of higher load-bearing capability are respectively supported at a support wall portion 5 which is also comparatively thick-walled. The support wall portions 5 also form an integral component part of the mask pad 1 and are embodied in the form of thick-wall zones of the front peripheral wall which extends in the zones b1, c and b2.

The degree of flexibility in opposite relationship to the application direction decreases along the sealing lip 3, starting from the zones 4 of high load-bearing capability, to the zenith Q at the side at the bridge of the nose, and then slowly rises to the outer edge point R.

In the illustrated embodiment, the mounting of the zone a of the sealing lip, 3, which is yielding in opposite relationship to the application direction Z, is achieved by means of a folding bellows structure of differing load-bearing capability.

The differing load-bearing capability is achieved here both by the geometry and arrangement of the bellows structure and also by a particular wall thickness configuration. That wall thickness configuration will be discussed in greater detail hereinafter in particular with reference to FIGS. 5 a-6 g.

The mask pad 1 further includes a peripherally extending frame 8 provided with a fixing profile means which is of a complementary configuration to a fixing profile portion provided on a mask base body (not shown).

The peripheral length of the frame 8 and the configuration thereof around a central axis z of the mask pad 1 are selected in such a way that, in conjunction with a mask base body, the arrangement provides for defined prestressing of the mask pad 1, in particular a tendency towards forward curvature in an outward direction.

In the illustrated embodiment the wall thickness of the sealing lip 3 is in the range of between 0.6 and 3.2 mm.

The configuration of the peripheral edge u which borders the nose receiving opening 2 is selected in such a way that there are formed two segments s1, s2 (FIG. 1 d) which project inwardly slightly relative to the axis z of the mask.

By virtue of the configuration of the peripheral edge u being matched to the convex curvature of the sealing lip 3, it is possible to achieve a deformation characteristic with which an expansion of the sealing lip 3 in the region of the peripheral edge results in a definedly increased surface pressure against the face of the wearer of the mask.

Provided in a front end center region c is a further zone of reduced load-bearing capability. That definedly reduced load-bearing capability is afforded here by a markedly reduced wall thickness. It is also possible to provide local folding bellows structures or rolling bellows structures in the zone c.

A particularly preferred embodiment of a sealing lip device is afforded by virtue of the fact that integrated into the same are outlet openings 50, by way of which a defined flow of gas can flow away out of the interior of the breathing mask. Those outlet openings are preferably of an outwardly conically tapering cross-section, as shown in FIG. 1 c.

Preferably, those outlet openings are initially closed for example by a thin film and are then opened as required for example by puncturing with a needle. As can further be seen from this sketch the mask pad 1 can be mounted to a mask base body 12 by way of a frame portion 8. For that purpose the arrangement preferably has a peripheral bead structure of a crochet needle-like cross-section and with rounded edges.

FIG. 2 shows a side view of a further embodiment of a mask pad 1. In this embodiment the frame 8 extends substantially in a flat frame-defining plane f.

The mask pad 1 also has in the sealing region of the bridge of the nose a local folding bellows structure 9 which provides for flexible suspension of the sealing lip 3.

A fold indentation 10 is also provided in the front region c (definition similar to FIG. 1 b). The arrangement afforded in that way defines an adaptation and articulation axis X or an instantaneous center of rotation about which the sealing lip 3 can be elastically tilted. The arrangement here is such that tilt angles α in a range of up to 15° are possible. Besides the tilting movement itself the sealing lip 3 can also experience individual deformation, corresponding to the facial architecture. In particular the peripheral edge u of the nose receiving opening is stretched.

When relatively large tilt angles are involved, here the bellows structure becomes effective as an abutment device and limits in an also elastically yielding manner further engagement of the bridge of the nose into the mask pad 1.

The bellows structure 9 has the greatest indentation depth t in the region of the end which is towards the bridge of the nose. That indentation depth t gradually decreases to the front end E of the bellows structure 9.

In the embodiment illustrated here, the end of the bellows structure 9 is of a rounded configuration. Advantageously, provided in the region of the front end E of the fold indentation is a microfold structure e which provides for a more uniform reduction in stresses in the material in that region. That affords improved durability.

FIG. 3 a shows a further embodiment of a mask pad 1 in conjunction with a mask body 12 which is only indicated.

This embodiment also has a local folding bellows structure 9. The geometry of this bellows structure 9 is so selected that the fold flanks 9 a, 9 b extend inclinedly relative to each other. Overall in this case also the indentation depth t in the region of the end towards the bridge of the nose is larger than in the other regions. The mask pad 1 also defines an adaptation axis X which extends in the region of the zones c1, b2 and c at the level of the nostrils of the wearer of the mask.

The mask pad 1 also has a higher degree of flexibility in opposite relationship to the application direction Z by virtue of the suspension arrangement provided here for suspending the sealing lip 3 at a local bellows structure 9, in the region of the zone a which seals off the bridge of the nose.

FIG. 3 b shows a further view of a breathing mask with a mask pad 1 according to the invention. The mask pad 1 is here fixed by way of a frame 8 to a mask base body 12. A bellows structure 9 is provided here in the region of the portion of the sealing lip 3 which seals off the bridge of the nose. In a departure from the above-described embodiments in this case also the peripheral wall of the mask pad is also of thin-wall configuration in the region of the bellows structure 9. The mask pad 1 is stretched onto the mask base body 12 with considerable expansion and stretching of the frame 8.

FIG. 4, in conjunction with a plan view onto a half of the sealing lip 3, illustrates the load-bearing capability and the flexibility of the mask pad 1.

The lowest level of flexibility E of the mask pad 1 obtains in the region b. The highest level of flexibility obtains in the region a which covers over the bridge of the nose and the upper side flanks of the nose of the mask wearer. Obtaining in the region c in addition to the flexibility in opposite relationship to the application direction Z there is also a relatively high level of flexibility in the radial direction.

The adaptation axis A extends through the zone b of relatively high load-bearing capability. When a predetermined depth of penetration into the mask pad 1 is exceeded, the bellows structure becomes operative in a region d as an abutment device and in that case causes a rapid rise in the pressure force F transmitted by way of the sealing lip 3, as is indicated by the dash-dotted line portion f1.

The particular mechanical properties of the suspension arrangement for the sealing lip 3 are preferably determined by the wall thickness in the region of the bellows structure 9 and by the indentation depth and the orientation of the bellows flanks 9 a, 9 b (FIG. 3 a).

FIGS. 5 a and 5 c show a preferred configuration of the wall thicknesses of the bellows structure 9. The mask pad 1 is fixed to a mask base body 12 in this case by way of a rounded profile structure 12 a which extends along the frame 8. In the illustrated embodiment that profile structure 12 a is of a crochet needle-like cross-section. Provided at least in a portion-wise manner in the region of the contact zone between the frame 8 and the mask base body 12 are peripherally extending profile legs 15 which, even in the case of a considerable relative movement, provide a secure sealing action.

Beneath the frame 8 there is initially a thick-wall portion 16 which gradually reduces to a first bellows hinge location or vertex 17. That bellows hinge location vertex 17 is adjoined by a first bellows flank limb 9 b. That bellows flank limb 9 b has in cross-section zones of differing wall thickness and extends to a bellows inner hinge location or vertex 18 defined by a thin-walled zone. The variable wall thickness of the flank limb 9 b forms an internal indentation region or thin wall portion 77 that promotes a hinged motion around the hinge location or vertex 17 (see FIG. 5 a).

The bellows inner hinge location or vertex 18 is in turn adjoined by a second bellows flank limb 9 a which also has zones of differing wall thickness. The variable wall thickness of the flank limb 9 a forms another internal indentation region or thin wall portion 78 that promotes a hinged motion around the hinge location or vertex 18.

Finally, the sealing lip 3 is suspended on the second bellows flank limb 9 a, at a vertex 79. The sealing lip 3 is here extremely thin-walled in comparison with the bellows structure 9.

The sealing pad cross-section illustrated here corresponds in qualitative terms to the sealing pad cross-section in the region of the zone identified as a1 in FIG. 4.

In the course of applying the mask pad to the face of a mask wearer, the sealing lip 3 firstly bears against the face. The bellows flank limbs 9 a, 9 b are then deflected resiliently inwardly, corresponding to the depth of engagement of the bridge of the nose, as illustrated by the arrows P1 and P2. In the case of particularly deep engagement of the bridge of the nose the inner surface of the sealing lip 3 possibly comes into contract in the region of the zone k with the inside surface, which faces theretowards, of the bellows flank limb 9 b. The bellows flank limb 9 b in turn can bear on the outside surface, which faces theretowards, of the bellows flank limb 9 a.

The kinematics of the sealing pad suspension configuration will be clear by reference to FIG. 5 c . Thus the frame can be viewed as a dixed suspension means K1 at which the bellows flank limb 9 b is mounted pivotably at the hinge location vertex 17. The inherent elasticity of the elastomeric material in the region of the hinge location vertex 17 is symbolically indicated by the spring F1.

The bellows inner hinge location vertex 18 also involves an inherently elastic characteristic which is indicated by the spring F2. The loose mounting K2 and the spring F3 are due to the fact that this involves a spatial, ring-like structure which also carries forces in the radial direction.

The hinge location or vertex 18 is adjoined by the bellows flank limb 9 b and same is adjoined by the diaphragm-like sealing lip 3.

As illustrated in FIG. 5 b, provided along the inner peripheral edge u is a microsealing lip structure by which a sealing edge which terminates in a thin configuration is slightly prestressed outwardly. The microsealing lip structure has a bead portion 19 which increases the resistance to tearing of the sealing lip 3.

The mechanics of this microsealing lip structure is indicated in FIG. 5 c by a spring F4 and a hinge location 20. The sealing lip which is elastically suspended in that way, as indicated by the small arrows, can be urged flexibly against the surface of the face of the mask wearer, as a consequence of the internal pressure obtaining in the interior of the mask.

As can be seen from FIG. 6 the mask pad 1 is preferably of differing cross-sections along its configuration around the axis Z of the mask, as is diagrammatically indicated here.

The cross-section illustrated in FIG. 6 a has a marked hinge characteristic with abutment properties.

The cross-section illustrated in FIG. 6 b already has a lower hinge characteristic and a smaller fold indentation.

In the regions of the cross-sections illustrated in FIGS. 6 c and 6 d the bellows property decreases still further.

The higher load-bearing capability of the cross-sections illustrated in FIGS. 6 d and 6 e is achieved by local thickenings R1, R2 which extend lens-like into the sealing lip. In the zones of high load-bearing capability, it is possible to forego the bellows structure, as has happened here.

The alternative cross-sections illustrated in FIGS. 6 f and 6 g are such that there is flexibility in the directions r1 and r2 indicated here. That affords improved adaptability, in terms of the upper lip architecture, immediately beside the load-bearing zones.

It is also possible for the bellows structure 9 to be of a thin-wall nature. The kinematics of a structure of that kind is diagrammatically shown in FIG. 7. The diaphragm-like sealing lip 3 is here suspended on two limbs (bellows flank limb 9 a, 9 b). This embodiment, even with low internal pressures in the mask, guarantees a high level of adaptability. The elasticity characteristics are illustrated, with reference to a unit force, for all loading angles, by the polar diagrams II1, II2 which are diagrammatically shown here. As can be seen, a defined degree of adaptability is afforded by the suspension arrangement according to the invention for the sealing lip 3, not only in opposite relationship to the application direction Z but also in all other directions. The location vectors π1, π2, π3 and π4 clearly show that flexibility in the region of the bellows inner hinge location or vertex 18. The mobility options of the bellows inner hinge location or vertex 18 are also transmitted (under the influence of the mask pad peripheral forces) to the suspension region of the sealing lip 3.

FIG. 8 diagrammatically shows a profile structure 21 which is provided in respect of a mask base body 12 and which advantageously provides for reliable fixing of the mask pad in the peripheral direction. The illustrated embodiment for that purpose has a plurality of individual fixing projections 22 along the periphery of the mask base body 12. As an alternative thereto or also in combination with that measure, it is also possible to provide further fixing means, in particular peg-like projections.

FIG. 9 shows in greatly simplified form the structure of a mold for producing the mask base body 12. By virtue of the aperture in the peripheral bead 23 in the region of the respective strap loops, it is possible for the strap loops to be injection molded integrally with the mask base body 12, without the need for sliding mold portions in that respect.

In the embodiment of the mask base body 12 diagrammatically illustrated here, provided in parallel with a respiratory gas passage 24 is a secondary passage 25 by way of which for example pressure measurement can be effected, without reductions in cross-section occurring in that case.

The tool here is of a three-part construction and includes an upper mold half 26, a lower mold half 27 and a sliding mold portion 28 which can be withdrawn in the direction r3 from the respiratory gas passage 24.

Although the invention has been described hereinbefore with reference to preferred embodiments in which there is a single fold indentation which does not extend around the entire periphery of the mask pad, the invention is not limited to embodiments of that kind.

For example it is possible for the bellows structure to be provided with a plurality of fold indentations, of which possibly one or more extend around the entire periphery of the mask pad.

An example of a corresponding cross-sectional configuration is shown in FIG. 10. The mask pad 1 which is here fixed to a mask base body 12 which is only indicated in respect of a portion thereof, by way of a peripheral bead structure of a crochet needle-like cross-section, has two local fold indentations 39, 49. The wall of those local fold indentations 39, 49 is matched in regard to a defined hinge and flexibility characteristic.

In this embodiment the sealing lip 3 is of a comparatively thick-wall nature. That cross-section is suitable in particular for silicone rubber material with an extremely low Shore hardness.

The breathing mask shown in FIG. 11 includes a mask base body 12 which is made from a preferably fully transparent thermoplastic material. Provided in a wall portion which in the application position of the mask is adjacent to the forehead region of the mask wearer is a connecting portion 60 which here is of a polygonal cross-section.

The sealing pad device 3 is fixed to the mask base body 12 by way of a peripheral bead structure (not visible here). The sealing pad device 3 has a bellows structure which extends locally from the upper end region to an adaptation axis A. Provided in the region of the adaptation axis A on both sides of the sealing pad are zones of higher load-bearing capability which are formed by thicker-walled, spherically curved zones of the sealing pad device.

For the purposes of fitting the breathing mask to the face of a mask wearer, provided at both sides of the mask are fixing devices 61, by way of which a head band (headgear 90 as illustrated in FIG. 12) can be coupled to the breathing mask.

On its top side the mask body 12 is provided with a projection 62 by which the mask body generally is stiffened, thereby affording an improved characteristic in terms of sound conduction through solids.

Also provided in the region of the top side of the mask body 12 are a plurality of outlet openings 63, 64, by way of which a low-noise, directed discharge flow of partially consumed respiratory air can occur from the interior of the mask. The discharge of that leakage gas flow is promoted by a break-away edge 65 of a spoiler-like configuration. The openings 64 direct the flow substantially in the direction indicated by the arrow P1. The openings 63 which are also provided on the opposite side (not visible here) of the projection 62 open in the directions P2 and P3.

FIG. 12 shows the breathing mask of FIG. 11 from a direction of view which is directed inclinedly from below onto the zone 4 of high load-bearing capability. It is also possible to see here, beside the local bellows structure 9, the region of the sealing lip 3 which bears against the face of the mask wearer. In the region of the zone a the mask is distinguished by a high level of adaptability to different nose bridge heights. In the zones b1 and b2 the mask pad 1 is supported in a defined manner against the face of the mask wearer. In the region c once again there is a higher level of flexibility and a higher degree of adaptability to different upper lip contours.

The mask pad is of such a design configuration that there is a relief of load in the region of the zones b1 and b2, as a consequence of the internal pressure in the mask which occurs in the context of over-pressure artificial respiration. The surface pressure of the mask pad in the region of the zones a and c is substantially determined by the internal pressure in the mask. In the peripheral direction the sealing pad 1 has a high level of radial stiffness whereby the tendency to oscillation of the sealing pad in relation to alternating artificial respiration pressures is markedly reduced.

FIG. 13 is a greatly simplified view in section through the region of the sealing lip device 3, which fits on the upper lip 70 of a mask wearer. In a transitional region from the sealing pad device into the hard shell body 12, the configuration of the cross-sections of the sealing pad device 3 and the hard shell body 12 is such that there is a substantially smooth transition in respect of the respective internal surfaces. That ensures a favorable flow path directly in the region of the nostrils of the mask wearer.

As indicated, in this case also there is a local bellows structure 66 which ensures improved adaptability to different upper lip architectures.

FIG. 14 a shows a portion of the arrangement illustrating the transitional region between the hard shell body 12 and the sealing pad device 1. Formed directly in the sealing pad device 1 is a leakage opening 67 which is here of a cross-section which decreases in the discharge direction. The cross-sections of that leakage opening 67 are preferably of the configuration diagrammatically shown in FIG. 15.

FIG. 14 b shows a further embodiment of a leakage opening 68 which is integrated into the sealing pad device 1. In the embodiment illustrated here a wall formed by the hard shell body 12 extends into the flow path. This embodiment can be cleaned in a particularly advantageous manner as the flow path is exposed over a large area after removal of the sealing pad device 1 from the hard shell body 12. Illustrated in FIG. 14 f is a view of a detail of that sealing pad, in the direction of view identified as x1. As can be seen therein the peripheral bead 12 a of the hard shell body 12 extends partially into the recess 69 formed in the cushion pad device 1.

In the embodiment shown in FIG. 14 c, provided in the region of the joint between the hard shell body 12 and the sealing pad device 1 in the hard shell body is a channel portion 76 by way of which there can be a discharge flow of gas, as indicated by dash-dotted lines. The exit region of the channel portion 76, as illustrated, opens into an outlet passage 71 which is defined jointly by the sealing pad device 3 and the hard shell body 12.

In the embodiment shown in FIG. 14 d, provided in the hard shell body 12 is at least one outlet passage 72 which goes into an aligned discharge passage 73 in the sealing device 1.

FIG. 14 e shows an embodiment of a leakage device in which a wall portion 74 which is integral with the sealing pad device 1 is taken from the interior to an outlet opening region 75 of the hard shell body 12. That wall portion 74 is here provided with an outlet opening 67 which tapers conically in the discharge direction and which is arranged coaxially with respect to a preferably considerably larger outlet opening 75 a.

The flow paths described with reference to FIGS. 14 a through 14 e are preferably of at least one of the cross-sections 78-84 diagrammatically shown in FIGS. 15 a-d.

FIG. 16 indicates a preferred location for providing the discharge flow openings which are provided jointly with the sealing pad device 1 or also separately therefrom. Preferably the discharge flow occurs in the region of the zone c in combination with the zones b1 and b2, but preferably larger volume flows are admitted in the region c. 

The invention claimed is:
 1. A sealing lip device for a breathing mask, the sealing lip device comprising: a receiving opening for receiving at least a nose tip region of a mask wearer, and a sealing lip which is formed from an elastomeric material and which surrounds the receiving opening and which is configured to cross a bridge of a nose of the mask wearer and which has a contact zone provided for bearing against a face of the mask wearer when the breathing mask engages the face of the mask wearer, wherein the sealing lip is elastically and yieldingly arranged in such a way that a first sealing lip zone has a higher degree of flexibility than a second sealing lip zone, the first sealing lip zone being configured to seal a region of the bridge of the nose and the second sealing lip zone being opposite the first sealing lip zone, and wherein the sealing lip device further includes a bellows structure that suspends the sealing lip, the bellows structure including an inwardly projecting portion that extends toward an interior of the breathing mask and terminates at a vertex, an elastomeric portion of the inwardly projecting portion having an elastomeric wall with a variable wall thickness, the inwardly projecting portion having an inwardly projecting indentation in the elastomeric wall which provides the variable wall thickness.
 2. A sealing lip device as set forth in claim 1, wherein the bellows structure forms an abutment device.
 3. A sealing lip device as set forth in claim 1, wherein the bellows structure has a hinge characteristic defined by different wall thicknesses.
 4. A sealing lip device as set forth in claim 1, wherein the bellows structure has a plurality of vertexes.
 5. A sealing lip device as set forth in claim 1, wherein the vertex is structured to extend from the nose bridge region into a region adjacent to the mask wearer's mouth when the mask engages the mask wearer's face.
 6. A sealing lip device as set forth in claim 1, wherein the vertex extends around at least a portion of a periphery of the sealing lip device.
 7. A sealing lip device as set forth in claim 1, wherein the flexibility of the sealing lip, which is related to an application direction, is structured to define an articulation axis.
 8. A sealing lip device as set forth in claim 1, wherein zones of higher load-bearing capability are provided in a region of the sealing lip and are configured to be positioned adjacent to the mask wearer's mouth when the mask engages the mask wearer's face, the zones of higher load-bearing capability having a higher load-bearing capability than other zones provided in the region of the sealing lip.
 9. A sealing lip device as set forth in claim 8, wherein the zones of higher load-bearing capability are formed by locally thickened zones of the sealing lip.
 10. A sealing lip device as set forth in claim 9, wherein the locally thickened zones are supported on a mask frame zone by way of a support structure which is formed in the sealing lip.
 11. A sealing lip device as set forth in claim 8, wherein the zones of higher load-bearing capability are of a pad configuration.
 12. A sealing lip device as set forth in claim 8, wherein the zones of higher load-bearing capability are each of a substantially crescent moon-shaped configuration in the region of the face-contact zone.
 13. A sealing lip device as set forth in claim 8, wherein a zone of reduced load-bearing capability is configured to be provided adjacent an upper lip of the mask wearer in a region of the sealing lip which is between the zones of higher load-bearing capability when the mask engages the mask wearer's face, the sealing lip device being flexible in an application direction and in an opposite direction of the application direction.
 14. A sealing lip device as set forth in claim 8, wherein the zones of high load-bearing capability are of a different color from thinner-wall zones.
 15. A sealing lip device as set forth in claim 1, wherein the sealing lip device is adapted to be mounted to a mask base body.
 16. A sealing lip device as set forth in claim 15, wherein the mask base body is formed by a hard shell.
 17. A sealing lip device as set forth in claim 16, wherein the hard shell has a conduit connection.
 18. A sealing lip device as set forth in claim 16, further comprising structure to fix a position of the sealing lip device with respect to the hard shell in a peripheral direction.
 19. A sealing lip device as set forth in claim 16, wherein there is imparted to the sealing lip device a prestressing which is achieved by elastic deformation upon coupling to the hard shell.
 20. A sealing lip device as set forth in claim 1, further comprising a coupling structure for coupling the sealing lip device to a hard shell.
 21. A sealing lip device as set forth in claim 1, further comprising a frame portion extending substantially in one plane.
 22. A sealing lip device as set forth in claim 21, wherein the frame portion is of a configuration which advances toward the sealing lip in a region of an articulation axis relative to a zone of high load-bearing capability.
 23. A sealing lip device as set forth in claim 1, wherein a wall thickness of a thin zone of the sealing lip is in the range of between 0.65 and 1.85 mm.
 24. A mold for producing a sealing lip device as set forth in claim 1, wherein a mold core device which in conjunction with an outer mold defines a mold cavity with a fold portion for forming a portion of the sealing lip device having a varying degree of flexibility.
 25. A mold as set forth in claim 24, wherein the outer mold is of a multi-part configuration.
 26. A mold as set forth in claim 24, wherein the outside of a sealing lip, which in use is towards the mask wearer, is formed by an outer mold portion in conjunction with the mold core device, wherein the outer mold portion has a peripherally extending mold cavity channel which defines the outside of the sealing lip.
 27. A mold as set for in claim 26, wherein an outer edge of the mold cavity channel extends in a region of the outer peripheral edge of the sealing lip.
 28. A sealing lip device as set forth in claim 1, wherein the elastomeric material comprises silicone rubber.
 29. A sealing lip device as set forth in claim 1, wherein the inwardly projecting portion comprises an externally facing surface and an internally facing surface, the inwardly projecting indentation being in the internally facing surface.
 30. A breathing mask comprising: a mask base body, and a sealing lip device comprising a mask base body engagement portion and a sealing lip formed from an elastomeric material and surrounding a receiving opening configured to receive at least a nose tip region of a mask wearer, the sealing lip being configured to cross a bridge of a nose of the mask wearer, and having a contact zone provided for bearing against a face of the mask wearer, wherein the sealing lip is elastically and yieldingly arranged so that the sealing lip has a higher level of flexibility in a first zone corresponding to a region of the bridge of the nose when the mask is mounted on the mask wearer's face than in a second zone opposite the first zone, wherein the sealing lip device further includes a bellows structure that suspends the sealing lip, the bellows structure including a first leg and a second leg, wherein the first and second legs converge toward an interior of the breathing mask and diverge toward an exterior of the breathing mask, wherein the first leg extends from the mask base body engagement portion to the second leg and has an elastomeric wall with a variable wall thickness, wherein the first leg has a relatively thin wall portion compared to adjacent portions of the elastomeric wall, and wherein the first leg comprises an externally facing surface and an internally facing surface, the relatively thin wall portion corresponding to an indentation in the internally facing surface.
 31. A breathing mask as set forth in claim 30, further comprising a hard shell injection molded to the sealing lip device.
 32. A breathing mask as set forth in claim 30, wherein the breathing mask is a nasal mask.
 33. A breathing mask comprising: a mask body; a sealing pad device which is formed from an elastomeric material and which in conjunction with the mask body delimits a mask internal space; and an outlet device for the discharge of at least partially consumed respiratory gas from the mask internal space, wherein the outlet device has a flow path portion extending through an elastomeric wall of the sealing pad device so that the flow path is at least partially defined by the sealing pad device, and wherein the elastomeric wall includes an inwardly projecting portion that extends toward an interior of the breathing mask and terminates at a vertex, an elastomeric portion of the inwardly projecting portion having an elastomeric wall with a variable wall thickness, the inwardly projecting portion having an inwardly projecting indentation in the elastomeric wall which provides the variable wall thickness.
 34. A breathing mask as set forth in claim 33, wherein the mask body is formed by a hard shell.
 35. A breathing mask as set forth in claim 33, wherein the sealing pad device is formed from a silicone rubber material.
 36. A breathing mask as set forth in claim 33, wherein the flow path portion is formed by an opening formed in the sealing pad device.
 37. A breathing mask as set forth in claim 33, wherein the flow path portion is formed by a channel which is formed in the mask body.
 38. A breathing mask as set forth in claim 33, wherein the flow path portion is in a region above a peripheral bead of the mask body and is at least partially aligned with an opening in the mask body.
 39. A breathing mask as set forth in claim 33, wherein provided at the sealing pad device is a portion which faces inwardly into the mask internal space and in which there is provided at least one outlet opening.
 40. An elastomeric cushion for a breathing mask, comprising: a sealing lip; a frame; and a bellows structure provided between the sealing lip and the frame, wherein the bellows structure includes an indentation with converging legs that converge toward an interior of the breathing mask, the indentation having an indentation depth that is variable in different regions of the bellows structure, and wherein one of the converging legs is oriented towards the frame and has a locally weakened region proximate the interior of the breathing mask, the locally weakened region being a thinned portion of an elastomeric wall that reduces a stiffness of the one converging leg, and wherein an elastomeric thickness on each side of the locally weakened region is greater than an elastomeric thickness of the locally weakened region.
 41. A cushion as set forth in claim 40, wherein the cushion has a generally triangular-shaped cross-section including an apex zone, a pair of side zones extending from the apex zone, and a bottom zone interconnected between the pair of side zones.
 42. A cushion as set forth in claim 41, wherein the bellows structure includes a bottom bellows structure extending along the bottom zone.
 43. A cushion as set forth in claim 41, wherein the indentation depth of the bellows structure indentation is greatest at the apex zone.
 44. A cushion as set forth in claim 40, wherein the sealing lip includes an apex zone having a length, a pair of side zones having a length, and a bottom zone having a length.
 45. A cushion as set forth in claim 44, wherein the length of the apex zone is longer than the length of the bottom zone.
 46. A cushion as set forth in claim 40, wherein the sealing lip has a thickness and the frame has a thickness.
 47. A cushion as set forth in claim 46, wherein the thickness of the sealing lip is less than the thickness of the frame.
 48. A cushion as set forth in claim 40, wherein the breathing mask is a nasal mask.
 49. A resilient cushion that is structured to engage a face of a patient and to form a seal between the face of the patient and a frame, the cushion comprising: a deformable bellows portion comprising a first deformable element and a second deformable element connected together at a vertex, the bellows portion extending about a perimeter of a region, the region being structured to be an enclosed region situated between the face and the frame when the cushion is engaged with the face, wherein the first deformable element comprises a first leg that extends from the vertex, the first deformable element being structured to be engaged with the face of the patient; the second deformable element comprises a second leg that extends from the vertex, the second deformable element being structured to be engaged with the frame, and an interior indentation in an elastomeric wall of the first or second deformable element promotes a hinged action around the vertex and provides a localized region of reduced stiffness.
 50. The cushion of claim 49, wherein the indentation extends along at least a portion of the perimeter that is structured to be situated adjacent the nose of the patient.
 51. The cushion of claim 50, wherein the indentation extends along a portion of the perimeter that is structured to extend across the bridge of the nose and adjacent the sides of nose.
 52. The cushion of claim 49, wherein the second deformable element comprises an attachment element disposed on the second leg opposite the vertex, the attachment element being structured to be connected with a supply apparatus, the indentation being situated between the vertex and the attachment element.
 53. The cushion of claim 49, wherein the bellows portion comprises an apex region that is structured to extend across the bridge of the nose of the patient, and wherein the bellows portion has a width measured in a direction extending generally away from the vertex and a depth measured in a direction extending generally transverse to the width, at least one of the width and the depth decreasing in a direction extending along the perimeter generally away from the apex region.
 54. A patient interface structured to be engaged with the face of a patient and to provide a flow of breathing gas to an airway of the patient, the patient interface comprising: a mask shell with a connecting portion adapted to connect to an air supply tube; a cushion according to claim 49; and headgear configured to support the breathing mask on a patient's head.
 55. A patient interface as set forth in claim 54, wherein the patient interface is a nasal mask.
 56. The cushion of claim 49, wherein the second deformable element comprises an externally facing surface and an internally facing surface, and wherein the interior indentation is in the internally facing surface.
 57. The cushion of claim 56, wherein a contour of the externally facing surface is substantially consistent with little variation between the vertex and the frame, and wherein a contour of the internally facing surface is variable between the vertex and the frame.
 58. A cushion for a breathing mask, the cushion comprising: a mask shell engaging portion configured to secure the cushion to a shell of the breathing mask; a sealing lip configured to form a seal with a patient's face when the cushion engages the patient's face, the sealing lip defining an opening adapted to receive at least a patient's nose; and a bellows portion configured to provide flexible suspension of the sealing lip, the bellows portion being connected to the mask shell engaging portion at a first vertex and connected to the sealing lip at a second vertex so that the bellows portion is between the mask shell engaging portion and the sealing lip, the bellows portion comprising an indentation defining a third vertex, the indentation having a first leg extending from the first vertex to the third vertex and a second leg extending from the second vertex to the third vertex, wherein a length of at least one of the first and second legs is greatest at the apex of the cushion, the first leg includes an internal indentation in an elastomeric wall so that an elastomeric wall thickness of the first leg varies between the first and third vertices, and the first leg projects radially inwardly from the first vertex, the first and second legs project radially outward from the third vertex, and the second leg projects radially inwardly from the second vertex.
 59. A cushion according to claim 58, wherein the sealing lip comprises a bead positioned at an end of the sealing lip.
 60. A breathing mask comprising: a mask shell with a connecting portion adapted to connect to an air supply tube; a cushion according to claim 58; and headgear configured to support the breathing mask on a patient's head.
 61. A breathing mask as set forth in claim 60, wherein the breathing mask is a nasal mask.
 62. A cushion according to claim 58, wherein a thickness of the elastomeric wall at the internal indentation is thinner than surrounding portions of the elastomeric wall.
 63. A cushion according to claim 58, wherein a degree of flexibility of the cushion is greatest toward an apex of the cushion.
 64. A cushion according to claim 58, wherein the elastomeric wall of the first leg comprises an external surface and an internal surface, and wherein the internal indentation is in the internal surface.
 65. A cushion according to claim 64, wherein a contour of the external surface is substantially consistent with little variation between the first vertex and the third vertex, and wherein a contour of the internal surface is variable between the first vertex and the third vertex. 